厄贝沙坦联合阿托伐他汀治疗早期糖尿病肾病临床观察

Effects of irbesartan combined with atorvastatin in the treatment of early diabetic nephropathy

目的探讨厄贝沙坦联合阿托伐他汀治疗早期糖尿病肾病的临床疗效。方法将武穴市第一人民医院诊治的58例早期糖尿病肾病患者随机分为观察组和对照组,每组29例。2组患者均给予控制血糖等常规治疗,并在此基础上,对照组给予口服厄贝沙坦(150 mg·d-1)治疗,观察组给予口服厄贝沙坦(150 mg·d-1)联合阿托伐他汀(40 mg·d-1)治疗。治疗6个月后观察比较2组治疗前后尿微量白蛋白排泄率(UAER)、血肌酐、血尿素氮、血脂、血糖及血压的变化。结果治疗6个月后2组患者UAER、血压均较治疗前明显降低(P<0.05),且观察组UAER水平明显低于对照组(P<0.05);观察组总胆固醇、三酰甘油、低密度脂蛋白水平较治疗前明显降低(P<0.05),而对照组治疗前后比较差异无统计学意义(P>0.05);2组治疗前后血肌酐、血尿素氮水平有所降低,但差异无统计学意义(P>0.05)。结论厄贝沙坦联合阿伐他汀治疗早期糖尿病肾病较单独应用厄贝沙坦临床治疗效果更加明显。

Objective To investigate the effects of irbesartan combined with atorvastatin in the treatment of early diabetic nephropathy（DN）.Methods Fifty-eight patients with early DN from the first people′s hospital of Wuxue city were randomly divided into observation group and control group,twenty-nine cases in each group.Based on the conventional therapy of controlling blood sugar,the control group was treated with irbesartan 150 mg·d-1,the observation group was given irbesartan 150 mg·d-1 combined with atorvastatin 40 mg·d-1.After treating for 6 months,the changes of urinary albumin excretion rate（UAER）,serum creatinine（Scr）,blood urea nitrogen（BUN）,lipids,blood glucose and blood pressure（BP） were compared before and after treatment.Results After treating for 6 months,the levels of UAER,BP were significantly lower than those before the treatment（P〈0.05） in the two groups（P〈0.05）,and the UAER level in observation group was significantly lower than that in control group（P〈0.05）;the levels of total cholesterol,triglycerides,low-density lipoprotein in the observation group were significantly lower than those before the treatment（P〈0.05）,but there was no significantly difference in control group（P〉0.05）;the Scr and BUN level in both groups were decreased,but there was no statistically significant（P〉0.05）.Conclusion The clinical effectiveness of irbesartan combined with atorvastatin in the treatment for early diabetic nephropathy is more obviously than giving irbesartan alone.